Psychological intervention for three COVID patients who suffered online violence.

Three patients diagnosed with COVID-19 were all young women in their thirties who have suffered from Internet violence in their personal life after hospitalization. They showed significant emotional distress such as, depression state, acute stress disorder, and dissociative disorder. The current study adopts short-term, individualized and comprehensive psychological interventions, including psychological support, encouragement, listening, safety confirmation, catharsis, psychological suggestion, and stimulation of internal potential to treat patients. The third case was provided with psychological interventions combined with antipsychotic treatment. After timely psychological interventions all three patients achieved sound results.Copyright © 2021 Chinese Medical Journals Publishing House Co.Ltd.

Findings from the ECHO Cohorts Regarding the Effects of the COVID-19 Pandemic

Background: Studies suggest perinatal infection with SARSCoV- 2 can induce adverse birth outcomes, but studies published to date have substantial limitations. Most have identified cases based upon their presentation for clinical care, and very few have examined pandemic-related stress which may also impact adverse birth outcomes. Objective(s): To evaluate the relationships between SARSCoV- 2 infection in pregnancy and pandemic-related stress with birth outcomes. Study Design: We conducted an observational study of 211 mother-newborn dyads in three urban cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) Program. Serology for SARS-CoV-2 was assessed in a convenience sample of prenatal maternal, cord serum or dried blood spots from births occurring between January 2020-September 2021. Specimens were assessed for IgG, IgM, and IgA antibodies to nucleocapsid, S1 spike, S2 spike, and receptor-binding domain. A Pandemic-related Traumatic Stress (PTS) scale was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Acute Stress Disorder criteria. Result(s): 36% were positive for at least one antibody type, chiefly IgG. Self-report of infection was not significantly correlated with combined serology. There were no differences in gestational age (GA), birth weight, preterm birth (PTB), or low birth weight (LBW) among seropositive mothers. However, IgM seropositive mothers had children with lower BW (434g, 95% CI: 116- 752), BW Z score-for-GA (0.73 SD, 95% CI 0.10-1.36) and were more likely to deliver preterm (OR 8.75, 95% CI 1.22-62.4). Associations with LBW sustained in sensitivity analyses limited to pre-vaccine samples, and PTS symptoms were not associated with birth outcomes. The addition of PTS did not substantially change associations with BW, although associations with PTB attenuated to near-significance. Conclusion(s): We identified decreased birth weight and increased prematurity in mothers IgM seropositive to SARS-CoV-2, independent of PTS. Though there are limits to interpretation, the data support efforts to prevent SARS-CoV-2 infections in pregnancy.

Acute stress disorder and post traumatic stress disorder after ICU admission for acute respiratory failure due to COVID-19

Introduction: ICU survivors may present symptoms of acute stress disorder(ASD) or post traumatic stress disorder (PTSD) [1], as defined by the Diagnostic and Statistical Manual of Mental Disorders. Prevalence of PTSD in ARDS affects 20% of survivors but is higher in SARS/ MERS patients [2];risk factors are delirium, ICU sedation, altered memories or ICU amnesia [3]. Method(s): We enrolled patients discharged from our ICU (Pavia-Italy) after admission for acute respiratory failure due to COVID-19. Written consent was collected. Inclusion criteria: age >= 18 years, ICU admission between February 2020 and July 2021 for severe COVID-19, SARSCoV-2 infection confirmed by positive nasal swab/tracheal aspirate, available follow-up visit. Exclusion criteria: refuse to attend the follow up visit, refuse to perform the psychological tests. To assess ASD/ PTSD we used the IES-R: a total mean score >= 33 was the cut-off value for ASD/PTSD;subscale scores for avoidance, intrusion, hyperarousal were calculated. Quantitative and categorical variables are expressed as median [IQR] and number (%). Result(s): Of the 491 patients admitted to ICU, 113 patients were included (males 84(74.3%), age 61.0[52.0-66.0] years, BMI 28.2[25.8- 31.6] kg/m2, SAPS2 31.0[26.0-41.5], ICU stay 17.0[8.0-28.0] days, invasive mechanical ventilation 61(54.0%). They were assessed in median 107.0 [82.0-150.0] days after ICU discharge. 37 patients (32.7%) had ASD/PTSD, higher than the expected 20% in general ARDS population (p < 0.001). Both intrusion 11.0[5.0-17.0] and avoidance 7.0[3.0-13.0] median scores were higher than hyperarousal 5.0[2.0-9.0]. Conclusion(s): ASD/PTSD is frequent after discharge to ICU for severe COVID-19, this prevalence is higher than other ARDS population, maybe for stigma, difficulties with quarantine and isolation. Patients have higher intrusion and avoidance scores, maybe because during the pandemic isolation was unavoidable.

NEI Congress 2023

The proceedings contain 53 papers. The topics discussed include: clinical study of lurasidone combined with nutritional intervention strategy in the treatment of chronic schizophrenia;analysis of clinical medication scheme and nursing measures of acute stress disorder complicated with delirium under the COVID-19;a study on the mental state of prisoners near the end of their sentence caused by a psychological anxiety case;a clinical study on the effect of peperidone combined with cognitive behavioral therapy on symptoms of schizophrenia;the clinical effect of feedforward control nursing combined with methylphenidate sustained-release tablets on children with attention deficit hyperactivity disorder;study on the effect of community legal consciousness health management on cognitive function of senile patients;effects of special sports training on autonomic nervous regulation;a study of positive intervention of music therapy and neurofeedback on negative emotions and attention in college students;and alleviating effect of the geriatric care system integrating physical and psychological on the common mental problems of the elderly.

Acute Stress among Nurses in Sweden during the COVID-19 Pandemic

Sweden was hit hard in the beginning of the COVID-19 pandemic with deaths per capita among the highest in Europe. The pandemic was a stressful time especially for healthcare workers caring for COVID-19 patients. Various studies have evaluated whether nurses caring for these patients had higher levels of acute stress, but typically with measures that either used older DSM-IV criteria for Acute Stress Disorder (ASD) or general measures of acute stress. We recruited an online sample (N = 101) of nurses in Sweden from COVID-19 specialized units (ICU), Emergency (ER), and other units (Other), and asked them to answer questionnaires retrospectively to the peak of infections in Sweden. We aimed to evaluate: 1) the psychometric properties of the translation of the Stanford Acute Stress Reaction Questionnaire-II (SASRQ-II, which follows DSM-5 criteria for ASD) into Swedish, 2) whether nurses in COVID-19 units had experienced more acute stress than nurses in other units, and 3) the extent of potential acute stress disorder. The SASRQ-II evidenced good construct, convergent and divergent validity, and good reliability. It showed that ICU nurses reported significantly more acute stress than the other two groups, a difference that could not be accounted for by demographic or other variables. A retrospective diagnosis of ASD using the SASRQ-II suggested that 60% of nurses might have fulfilled ASD criteria, but no differences across groups were found. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Micro-dose, macro-impact: Leveraging psychedelics in frontline healthcare workers during the COVID-19 pandemic

Background and aims: The COVID-19 pandemic exacerbated pre-existing high-levels of physician stress and burnout1. In order to help treat frontline colleagues who were diagnosed with acute stress disorder, we chose a non-psychedelic, ketamine micro-dose treatment strategy for symptom management. Methods: We provided care virtually, and all patients were prescribed sublingual ketamine once daily. Each patient was evaluated using the NIH-PROMIS CAT assessments for stress, depression, anxiety, and PTSD via a remote, HIPAA compliant patient self-reporting platform. Progress was tracked and assessed against a baseline value obtained prior to the start of treatment. Patient progress was evaluated at a 4-6-week interval. Patients did not report any significant side effects to the treatment regimen. Results: 100% (25/25) of patients experienced improved anxiety, 92% (23/25) experienced improved stress, 96% (24/25) experienced improved PTSD, and 91% (20/22) experienced improved depression. Conclusions: While we cannot draw definitive conclusions from the association demonstrated by this data, we believe these results demonstrate that further research into the efficacy of daily, short-term ketamine micro-doses for treatment of acute stress disorder is warranted. © 2022 The Author(s).

Workplace violence, trauma, and the lived experience of corrections officers: A phenomenological study

Corrections officers are required to ensure compliance from inmates, and sometimes they have to use force, resulting in violent encounters. Such incidents can be traumatic for those directly and indirectly involved. Previous studies examined the working conditions of jail staff, but their focus was not primarily directed toward corrections officers. The purpose of this qualitative phenomenological study was to explore how everyday occurrences of violence associated with working in jails influence corrections officers' physiological well-being. The theory of constructed emotions framed this study. Recruiting was conducted using a demographic and interest survey distributed through Facebook. Using purposive sampling, semi structured interviews were conducted using the Zoom platform (due to the COVID-19 pandemic) and face-to-face with 11 active-duty corrections officers working in a complex jail system in a northeastern metropolitan region. The study addressed the lived experiences of corrections officers who experienced or witnessed workplace violence by inmates and how inmates cope with trauma. Interview responses were coded and analyzed to identify common themes. The corrections officers' most common concerns were lack of follow-up after a use-of-force encounter and workplace policies about the use of force that are ineffective and detrimental. Other findings indicated fear, helplessness, stress, anxiety, and anger. Policymakers, key stakeholders, and others may lead to positive social change by using these findings in developing effective and competent strategic planning, management, and policy implementation to support corrections officers and offer them better ways to process the trauma that they experience throughout their careers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Echoes from the past: adjustment of aging former prisoners of war to the COVID-19 pandemic.

BACKGROUND: The aim of this study was to examine whether exposure to previous traumatic events is a risk factor for stress reactions during this pandemic. Capitalizing on a 29-year longitudinal study of Israeli ex-prisoners of war (ex-POWs) and combat veterans, we examined whether captivity is a risk factor for fear of coronavirus disease 2019 (COVID-19) and COVID-19-induced acute stress disorder (COVID-19 ASD) beyond the effects of combat exposure and other stressful life events. In addition, we examined the contribution of captivity experiences (severity of captivity, experience of solitary confinement, and suffering during captivity) and veterans' appraisal of the impact of their war-related experiences on adjustment to the current quarantine and isolation to fear of COVID-19 and COVID-19 ASD. METHODS: One-hundred-and-twenty Israeli ex-POWs from 1973 Yom Kippur War and 65 matched controls (combat veterans from the same war) filled out self-report questionnaires 18 (T1), 35 (T2), 42 (T3), and 47 (T4) years after the war. RESULTS: Findings revealed that although ex-POWs and controls did not differ in their level of exposure to COVID-19, ex-POWS reported higher levels of fear of COVID-19 and COVID-19 ASD than controls. Suffering during captivity, measured at 1991, and participants' appraisal of the extent to which their war-related experiences affected adjustment to COVID-19 were significantly associated with fear of COVID-19 and COVID-19 ASD. CONCLUSIONS: The findings of the study demonstrate the long-term effects of exposure to traumatic experiences (captivity) during young adulthood on adjustment to an unrelated collective stress, such as COVID-19, 40 years later.

The impact of the COVID-19 pandemic on the psychological health of midwives

Objective. The SARS-CoV-2 pandemic has changed the therapeutic relationship between women and midwives and these changes have been perceived as stressors. The aim of this work is to investigate the effect of these stressors on midwives through an online questionnaire. Materials and Methods. The VRS tool was used, and statistical analysis was performed using Stata. Results. Significant differences were found in the somatization cluster and in subjective stress cluster. Conclusions. The analysis shows that there is a need to implement resilience-enhancing factors such as communication, sharing of distress and the presence of support. Copyright © 2022, EDRA S.p.A. All rights reserved.

Women's mental health during the COVID 19 pandemic and the problem of domestic violence in a lockdown situation

Introduction: The current situation caused by restrictive measures related to the COVID-19 pandemic provokes the high level of aggressiveness and all forms of domestic violence. These results in mental health problems. Objective(s): The purpose of this study was to find out the consequences of domestic violence against women and to identify psychological problems and mental disorders in women. Method(s): Acohort of 18 females was examined by psychiatrists and psychologists. All women turned to specialists at the Moscow Institute of Psychiatry for help. Result(s): All women were victims of violence by their husbands and partners. Lockdown situation associated with COVID 19 pandemic has exacerbated the problem of domestic violence. Clinical assessment has revealed different depressive symptoms, anxiety, fear, suicidal tendencies forming the clinical picture of adjustment disorder (2 cases), acute reaction to stress (3 cases), posttraumatic stress disorder (2 cases), depressive episode (8 cases), eating disorders behavior in the form of bulimia and anorexia (3 cases). Conclusion(s): The research has revealed that domestic abuse against women associated with lockdown situation during the COVID 19 pandemic often results in psychological and longterm mental health problems. In these cases, prevention is needed to combat violence against women with the participation of public health specialists, psychologists, psychiatrists, sociologists.

Emotional impact on Spanish health professional because of the COVID19 crisis

Introduction: The COVID-19 pandemic has positioned health professionals around the world in an unprecedented situation, having to work in extreme conditions. The reactions of healthcare personnel that concern us most are the negative psychological effects of the pandemic, such as exhaustion, moral injury, acute stress reactions, anxiety, depression or posttraumatic stress disorder. Objective(s): To assess the impact of the COVID19 crisis on mental health of Spanish health professionals during the start of the pandemic. Method(s): A descriptive, cross-sectional study is carried out, in which the population sample to be studied was the health professionals who responded to the online questionnaire designed to assess the emotional impact caused by the COVID-19 health crisis. The questionnaire collects sociodemographic and labor data, which correspond to the independent variables of the study. The dependent variables correspond to the two scales used in the questionnaire (SAS and SASRQ scales) Results: The population sample was 473 people. Analyzing the results of the SAS scale, 26.5% of the sample had anxiety symptoms in a normal range, 44.3% had mild-moderate anxiety levels, 24.4% marked-severe anxiety and 4, 9% had extreme anxiety levels. The SARQ questionnaire assesses the presence of an acute stress disorder. In our study, 31.6% of those surveyed had this type of disorder. Conclusion(s): Immediate interventions and support for health professionals are essential to improve psychological resilience and avoid the appearance of mental health problems.

Mental disorders and psychological problems of women-victims of domestic violence during selfisolation in the covid 19 pandemic

Introduction: Domestic violence is a troubling problem, but it has acquired a new, previously unknown significance during the COVID 19 pandemic. According to WHO, the number of calls from victims of domestic violence to hotlines during quarantine in many countries has increased by an average of 5 times. Objective(s): The purpose of this study was to find out the consequences of domestic violence against women and to identify psychological problems and mental disorders. Attention was paid to the mental health of victims of violence in self - isolation during COVID-19 pandemic. Method(s): We analyzed the psychological problems and mental disorders of women who applied to the newly created hotline for women at the Serbsky Center in Moscow during the COVID 19 pandemic. Result(s): The situation caused by restrictive quarantine measures related to the COVID-19 pandemic provokes aggressiveness and all forms of domestic violence.Clinical interview has revealed depression, anxiety, fear, low self-esteem, self-harm behavior, which formed the clinical picture of adaptation disorders, acute stress disorders, PTSR, psychosomatic disorders, substance abuse), sexual dysfunctions, eating disorders in the form of bulimia and anorexia. Conclusion(s): The study requires taking into account social, economic and gender characteristics. In all types of emergencies, including epidemics, violence against women tends to increase. This is facilitated by a number of factors, such as the crowding of the stay,a decrease in prosperity, provocation of alcohol abuse, state of uncertainty.

Workplace violence, trauma, and the lived experience of corrections officers: A phenomenological study

Corrections officers are required to ensure compliance from inmates, and sometimes they have to use force, resulting in violent encounters. Such incidents can be traumatic for those directly and indirectly involved. Previous studies examined the working conditions of jail staff, but their focus was not primarily directed toward corrections officers. The purpose of this qualitative phenomenological study was to explore how everyday occurrences of violence associated with working in jails influence corrections officers' physiological well-being. The theory of constructed emotions framed this study. Recruiting was conducted using a demographic and interest survey distributed through Facebook. Using purposive sampling, semi structured interviews were conducted using the Zoom platform (due to the COVID-19 pandemic) and face-to-face with 11 active-duty corrections officers working in a complex jail system in a northeastern metropolitan region. The study addressed the lived experiences of corrections officers who experienced or witnessed workplace violence by inmates and how inmates cope with trauma. Interview responses were coded and analyzed to identify common themes. The corrections officers' most common concerns were lack of follow-up after a use-of-force encounter and workplace policies about the use of force that are ineffective and detrimental. Other findings indicated fear, helplessness, stress, anxiety, and anger. Policymakers, key stakeholders, and others may lead to positive social change by using these findings in developing effective and competent strategic planning, management, and policy implementation to support corrections officers and offer them better ways to process the trauma that they experience throughout their careers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Psychopathological states among Congolese health workers during the first wave of COVID-19 pandemic: links with emotion regulation and social support.

Background: The COVID-19 pandemic is an unprecedented stressor for frontline healthcare workers, notably increasing acute stress disorder and depression rates. Emotion regulation and social support could be major protective factors against such psychopathological states, but their role has not been explored outside Western contexts. Objective: To assess the association between emotion regulation, social support, acute stress disorder, and depression among healthcare workers directly confronted with the first wave of COVID-19 pandemic in the eastern Democratic Republic of the Congo. Method: A cross-sectional study assessed acute stress disorder, depression, adaptive (i.e. acceptance, positive refocusing, …) and maladaptive (i.e. self-blame, rumination, catastrophizing, …) emotion regulation strategies, social support (instrumental, emotional, and informational levels), as well as self-reported situations and feelings related to COVID-19, in a population of 252 frontline healthcare workers (121 women; 131 men; mean age: 39 ± 11 years old) at the Referral General Hospital of Bukavu. We also explored the relations between these variables through bivariate and multivariate logistic regression. Results: Forty percent of participants presented symptoms of depression, and 16% presented acute stress disorder. In bivariate logistic regression, these psychiatric outcomes were associated with the availability of a COVID-19 protection kit [OR = 0.24 (0.12-0.98)], hostility toward health workers [OR = 3.21 (1.23-4.21)], putting into perspective [OR = 0.91 (0.43-0.98)], self-blame [OR = 1.44 (1.11-2.39)], catastrophizing [OR = 1.85 (1.01-4.28)], blaming others [OR = 1.77 (1.04-3.32)], emotional support [OR = 0.83 (0.49-0.98)], instrumental support [OR = 0.74 (0.28-0.94)], and informational support [OR = 0.73 (0.43-0.98)]. In multivariate logistic regression, hostility [OR = 2.21 (1.54-3.78)], self-blame [OR = 1.57 (1.02-2.11)], rumination [OR = 1.49 (1.11-3.13)] and emotional support [OR = 0.94 (0.65-0.98)] remained significantly associated with psychiatric outcomes. Conclusion: Depression and acute stress disorder were highly prevalent among Congolese healthcare workers during the first wave of the COVID-19 health pandemic. Hostility, self-blame, rumination, and social support were associated with depression and/or acute stress disorder and should be targeted by interventions aiming to support health workers' wellbeing. HIGHLIGHTS: Frontline health workers presented high prevalence of acute stress disorder (16%) and depression (40%) during the first wave of COVID-19 pandemic in the Eastern Democratic Republic of the Congo, as they were working in hostile environment without enough protection kits.Acute stress disorder and depression were negatively associated with adaptive emotion regulation and social support; and positively with maladaptive emotion regulation.Intervention aiming to support health workers in pandemics should target emotion regulation and social support.

Antecedentes: La pandemia de COVID-19 es un factor estresante sin precedentes para los trabajadores de atención médica de primera línea, que aumenta notablemente las tasas de trastorno por estrés agudo y depresión. La regulación de las emociones y el apoyo social podrían ser factores protectores importantes contra tales estados psicopatológicos, pero su papel no ha sido explorado fuera de los contextos occidentales.Objetivo: Evaluar la asociación entre la regulación de las emociones, el apoyo social, el trastorno de estrés agudo y la depresión entre los trabajadores de la salud que confrontaron directamente la primera ola de la pandemia de COVID-19 en el este de la República Democrática del Congo.Método: Un estudio transversal evaluó el trastorno de estrés agudo, la depresión, estrategias de regulación emocional adaptativas (es decir, aceptación, refocalización positiva, …) y desadaptativas (es decir, autoculpabilización, rumiación, catastrofización, …), apoyo social (niveles instrumental, emocional, e informacional), así como situaciones y sentimientos autoinformados relacionados con el COVID-19, en una población de 252 trabajadores de salud de primera línea (121 mujeres; 131 hombres; edad media: 39 ± 11 años) en el Hospital General de Referencia de Bukavu. También exploramos las relaciones entre estas variables mediante regresión logística bivariada y multivariada.Resultados: Cuarenta por ciento de los participantes presentó síntomas de depresión y el dieciséis por ciento presentó trastorno de estrés agudo. En regresión logística bivariada, estos resultados psiquiátricos se asociaron con la disponibilidad de un kit de protección COVID-19 [OR = 0.24 (0.12­0.98)], hostilidad hacia los trabajadores de la salud [OR = 3.21 (1.23­4.21)], postura en perspectiva [ OR = 0.91 (0.43­0.98)], autoculpabilización [OR = 1.44 (1.11­2.39)], catastrofización [OR = 1.85 (1.01­4.28)], heteroculpabilización [OR = 1.77 (1.04­3.32)], apoyo emocional [OR = 0.83 (0.49­0.98)], apoyo instrumental [OR = 0.74 (0.28­0.94)] y apoyo informativo [OR = 0.73 (0.43­0.98)]. En la regresión logística multivariada, hostilidad [OR = 2.21 (1.54­3.78)], autoculpabilización [OR = 1.57 (1.02­2.11)], rumiación [OR = 1.49 (1.11­3.13)] y apoyo emocional [OR = 0.94 (0.65­0.98)] permanecieron significativamente asociados con los resultados psiquiátricos.Conclusión: La depresión y el trastorno de estrés agudo fueron muy frecuentes entre los trabajadores de la salud congoleños durante la primera ola de la pandemia sanitaria de COVID-19. La hostilidad, la autoculpabilización, la rumiación y el apoyo social se asociaron con depresión y/o trastorno de estrés agudo y deberían ser el objetivo de las intervenciones destinadas a apoyar el bienestar de los trabajadores de la salud.

Acute stress disorder and job burnout in primary and secondary school teachers during the COVID-19 pandemic: The moderating effect of sense of control.

The study aim was to examine the relationship between acute stress disorder and job burnout among primary and secondary school teachers, and to explore the moderating effect of sense of control on this relationship. A total of 751 teachers completed self-report questionnaires during the COVID-19 pandemic. The results showed that acute stress disorder, emotional exhaustion, and depersonalization were significantly lower in female teachers than in male teachers. Age was positively associated with acute stress disorder and negatively associated with inefficacy. Acute stress disorder was significantly and positively associated with emotional exhaustion and depersonalization dimensions of job burnout. The relation between acute stress disorder and inefficacy was moderated by sense of control: acute stress disorder was positively associated with inefficacy when the sense of control was strong and was negatively associated with inefficacy when the sense of control was weak. These findings demonstrate that acute stress disorder is a risk factor for job burnout, and that sense of control is a protective factor for some aspects of job burnout. However, in individuals with a strong sense of control, acute stress disorder is associated with greater inefficacy, suggesting that sense of control can both positively and negatively affect burnout.

Psychiatric reaction of an intensive care unit survivor in the context of coronavirus disease 2019: a case report.

BACKGROUND: The coronavirus disease 2019 pandemic has had a serious impact on global mental health, particularly in intensive care unit survivors. Given the lethal potential and unpredictability of coronavirus disease 2019, a high risk of posttraumatic stress disorder was identified in the beginning of the crisis. There are insufficient details in current literature and no official guidelines available for the treatment and follow-up of acute stress disorder and the prevention of posttraumatic stress disorder for intensive care unit survivors in the context of coronavirus disease 2019. CASE PRESENTATION: We hereby describe a 67-year-old Swiss patient presenting a psychiatric reaction in the context of coronavirus disease 2019. He was admitted to the intensive care unit due to severe acute respiratory distress syndrome from severe acute respiratory syndrome coronavirus 2 and intubated for 13 days. Afterwards, there was a severe worsening of acute renal failure prompting hemodialysis, and he developed delirium. Psychiatric liaison was requested 4 days post-intubation because the patient presented residual symptoms of delirium, false memories about the real context of his medical care, and ideas of persecution toward medical caregivers. He suffered from a very strong peritraumatic reaction, then developed an acute stress disorder linked with his care on the intensive care unit. We looked for strategies to prevent progression from acute stress disorder to posttraumatic stress disorder. We proceeded to the following therapeutic interventions: intensive psychiatric follow-up, intensive care unit diary, and low-dose antipsychotic treatment. The aim of our psychotherapeutic approach was to allow him to increase his feeling of security and to cope with the reality of his traumatic experience. He showed clinical improvement in his mental state after 3 months, despite several predictive factors of evolution to post-intensive care unit posttraumatic stress disorder. CONCLUSION: This case report illustrates how a delusional clinical presentation after intensive care in the context of coronavirus disease 2019 can hide psychotraumatic symptoms. It is important to highlight that the intensive care unit diary completed by the intensive care team and the follow-up by the psychiatric liaison team helped the patient reconstruct an appropriate and coherent account. Further studies are needed to determine the psychiatric effects of coronavirus disease 2019 and to assess early and appropriate psychiatric intervention for patients hospitalized for coronavirus disease 2019 to prevent posttraumatic stress disorder.

Acute stress disorder in patients with accidental traumatic fractures: What can we do.

AIM: To evaluate the potential influencing factors of acute stress disorder (ASD) in patients with accidental traumatic fractures to provide evidence for clinical nursing care. DESIGN: A retrospective study. METHODS: Patients with traumatic fractures treated in our hospital from 1 January 2020 to 30 November 2021 were included. The characteristics of ASD and no ASD patients were assessed. RESULTS: A total of 468 patients with traumatic fractures were included, the incidence of ASD was 28.20%. Logistic regression analysis showed that age ≤50 years (OR2.918, 95% CI1.994 ~ 3.421), female (OR2.074, 95% CI1.489 ~ 3.375), AIS-ISS at admission ≥20 (OR3.981, 95% CI2.188 ~ 5.091), VAS at admission≥7 (OR2.804, 95% CI2.027 ~ 3.467), introverted personality (OR1.722, 95%CI1.314 ~ 2.432) and CD-RISC at admission≤60 (OR3.026, 95% CI2.338 ~ 4.769) were the risk factors of ASD in patients with traumatic fractures (all p < .05). CONCLUSIONS: The development of ASD in patients with traumatic fractures is affected by multiple factors. Medical workers should take early and timely management and nursing measures for related risk factors to reduce the occurrence of ASD.

Acute Stress among Nurses in Sweden during the COVID-19 Pandemic

Sweden was hit hard in the beginning of the COVID-19 pandemic with deaths per capita among the highest in Europe. The pandemic was a stressful time especially for healthcare workers caring for COVID-19 patients. Various studies have evaluated whether nurses caring for these patients had higher levels of acute stress, but typically with measures that either used older DSM-IV criteria for Acute Stress Disorder (ASD) or general measures of acute stress. We recruited an online sample (N = 101) of nurses in Sweden from COVID-19 specialized units (ICU), Emergency (ER), and other units (Other), and asked them to answer questionnaires retrospectively to the peak of infections in Sweden. We aimed to evaluate: 1) the psychometric properties of the translation of the Stanford Acute Stress Reaction Questionnaire-II (SASRQ-II, which follows DSM-5 criteria for ASD) into Swedish, 2) whether nurses in COVID-19 units had experienced more acute stress than nurses in other units, and 3) the extent of potential acute stress disorder. The SASRQ-II evidenced good construct, convergent and divergent validity, and good reliability. It showed that ICU nurses reported significantly more acute stress than the other two groups, a difference that could not be accounted for by demographic or other variables. A retrospective diagnosis of ASD using the SASRQ-II suggested that 60% of nurses might have fulfilled ASD criteria, but no differences across groups were found.

Differences Between the Psychiatric Symptoms of Healthcare Workers Quarantined at Home and in the Hospital After Contact With a Patient With Middle East Respiratory Syndrome.

Objective: Although quarantine is an effective measure for the prevention of the spread of infectious diseases, it may have negative effects on the mental health of the isolated individual. During the 2015 outbreak of the Middle East Respiratory Syndrome (MERS) in Korea, healthcare workers came in contact with patients with MERS were quarantined either at home or in a hospital ward. In this study, we aimed to compare the psychiatric symptoms of these employees according to the method of quarantine. Methods: All 146 quarantined staff completed self-report questionnaires. Depressive symptoms were measured using the Patient Health Questionnaire-9, anxiety symptoms were assessed using Spielberger's State-Trait Anxiety Inventory, and acute stress disorder (ASD) symptoms were evaluated using the Stanford Acute Stress Reaction Questionnaire. Results: The in-hospital quarantine group had a higher rate of symptoms of depression (p < 0.001) and ASD (p = 0.014) than the group quarantined at home. Logistic regression analysis showed that respondents quarantined in the hospital (OR = 6.342; 95% CI 1.853-21.708) and those quarantined for longer periods (OR = 1.153, 95% CI = 1.036-1.285) had a higher risk of depressive symptoms. Conclusions: In-hospital quarantine and quarantine for longer periods increase the risk of depressive symptoms. When quarantine measures are taken, certain measures are needed to minimize the risk of psychiatric problems. Appropriate interventions should be implemented if psychiatric problems occur.